PANUPONG LISAWAT (Credential# 890756) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
PANUPONG LISAWAT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0046218. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 4 Fox Tail Ln, Brookfield, CT 06804. The current status is active.
| Licensee Name | PANUPONG LISAWAT |
| Credential ID | 890756 |
| Credential Number | CSP.0046218 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
4 Fox Tail Ln Brookfield CT 06804 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2009-09-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1135142 | 1.051569 | Physician/Surgeon | 2013-01-02 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 4 Fox Tail Ln |
| City | Brookfield |
| State | CT |
| Zip Code | 06804 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Injik Lee | 4 Fox Tail Ln, Brookfield, CT 06804-3705 | Emergency Medical Responder | 2013-02-21 ~ 2015-10-01 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Juan Liang | 6 Tara Dr, Brookfield, CT 06804 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Lenore A Fox · Castellano | 16 Johns Rd, Brookfield, CT 06804 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Xuefang Chen | 13 Hillside Court, Brookfield, CT 06804 | Real Estate Salesperson | ~ |
| J Scott Williams | 30 Obtuse Road South, Brookfield, CT 06804 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Liudmila Yakauleva | 317 Federal Road Suite C, Brookfield, CT 06804 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Brandi L Hennessey | 24 Riverview Court, Brookfield, CT 06804 | Real Estate Salesperson | ~ |
| Medical Warehouse Inc | 72 Grays Bridge Rd, Brookfield, CT 06804 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Heather Lynn Edelmann | 87 Heatherwood Drive, Brookfield, CT 06804 | Notary Public Appointment | 2020-06-25 ~ 2025-06-30 |
| Xiaoming Zheng | 540 Federal Rd, Brookfield, Connecticut 06804, Brookfield, CT 06804 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Shop Rite | Federal Rd, Brookfield, CT 06804 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06804 | |||
| City | Brookfield |
| Zip Code | 06804 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Brookfield |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Shu Pan | 360 State St Apt 702, New Haven, CT 06510-3602 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| May Chaaban | Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2016-08-01 ~ 2017-02-28 |
Please comment or provide details below to improve the information on PANUPONG LISAWAT.
| Data Provider | Connecticut Department of Consumer Protection |
| Jurisdiction | Connecticut |
| Related Datasets | Connecticut Business Registrations, Connecticut Child Care Facilities |
This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).